Abstract
After the first case of COVID-19 emerged in China on December 8, 2019, the coronavirus disease 2019 (COVID-19) quickly spread throughout the world. Although the illness is typically thought to be a respiratory infection, cases of severe, perhaps fatal cardiac damage have been linked to this virus. By attaching themselves to the angiotensin-converting enzyme 2 (ACE-2) receptor, coronaviruses can harm cardiac myocytes. Among COVID-19-affected patients, myocardial infarction, myocarditis, heart failure, cardiac arrhythmias, and Takotsubo cardiomyopathy are common cardiac clinical symptoms.
It Is possible to observe certain heart abnormalities both during and after an infection. Myoglobin, troponin, creatine kinase-MB, lactate dehydrogenase (LDH), plasma interleukin-6, and N-terminal pro-b-type natriuretic peptide (NT-proBNP) have all been observed to be elevated in COVID-19-associated cardiac damage. Electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), endomyocardial biopsies, echocardiography (Echo), and computerized tomography (CT-Scan) are the diagnostic modalities employed in cases of myocardial damage caused by COVID-19. This review of the literature will go into great detail about the etiology, clinical presentation, and diagnosis of COVID-19-related myocardial damage.
Keywords: troponin, echocardiography, dysrhythmia, myocarditits, acute myocardial infection,sars-cov-2,COVID-19,cardiovascular insult,myocardial injuries.
References
- Wu Z, McGoogan JM: Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020, 323:1239-1242. 10.1001/jama.2020.2648
- Coronavirus Cases: Statistics and Charts – Worldometer. (2023). Accessed: January 09, 2023: https://www.worldometers.info/coronavirus/coronavirus-cases/.
- Parohan M, Yaghoubi S, Seraji A: Cardiac injury is associated with severe outcome and death in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. Eur Heart J Acute Cardiovasc Care. 2020, 9:665-677. 10.1177/2048872620937165
- Lala A, Johnson KW, Januzzi JL, et al.: Prevalence and impact of myocardial injury in patients hospitalized with COVID-19 infection. J Am Coll Cardiol. 2020, 76:533-546. 10.1016/j.jacc.2020.06.007
- Guzik TJ, Mohiddin SA, Dimarco A, et al.: COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020, 116:1666-1687. 10.1093/cvr/cvaa106
- Klein NP, Lewis N, Goddard K, et al.: Surveillance for adverse events after COVID-19 mRNA vaccination. JAMA. 2021, 326:1390-1399. 10.1001/jama.2021.15072
- Chen L, Li X, Chen M, Feng Y, Xiong C: The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2. Cardiovasc Res. 2020, 116:1097-1100. 10.1093/cvr/cvaa078
- Li W, Moore MJ, Vasilieva N, et al.: Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature. 2003, 426:450-454. 10.1038/nature02145
- Azevedo RB, Botelho BG, Hollanda JV, et al.: COVID-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens. 2021, 35:4-11. 10.1038/s41371-020-0387-4
- Kuba K, Imai Y, Rao S, et al.: A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005, 11:875-879. 10.1038/nm1267
- Huang C, Wang Y, Li X, et al.: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020, 395:497-506. 10.1016/S0140-6736(20)30183-5
- Deshmane SL, Kremlev S, Amini S, Sawaya BE: Monocyte chemoattractant protein-1 (MCP-1): an overview. J Interferon Cytokine Res. 2009, 29:313-326. 10.1089/jir.2008.0027
- Adeghate EA, Eid N, Singh J: Mechanisms of COVID-19-induced heart failure: a short review. Heart Fail Rev. 2021, 26:363-369. 10.1007/s10741-020-10037-x
- Chen H, Wang C, Li J, et al.: Chinese herbal formula, huayu tongbi fang, attenuates inflammatory proliferation of rat synoviocytes induced by IL-1β by regulating proliferation and differentiation of T lymphocytes. Evid Based Complement Alternat Med. 2020, 2020:1706837. 10.1155/2020/1706837
- Xie Y, Wang X, Yang P, Zhang S: COVID-19 complicated by acute pulmonary embolism. Radiol Cardiothorac Imaging. 2020, 2:e200067. 10.1148/ryct.2020200067
- Danzi GB, Loffi M, Galeazzi G, Gherbesi E: Acute pulmonary embolism and COVID-19 pneumonia: a random association?. Eur Heart J. 2020, 41:1858. 10.1093/eurheartj/ehaa254
- McFadyen JD, Stevens H, Peter K: The emerging threat of (micro)thrombosis in COVID-19 and its therapeutic implications. Circ Res. 2020, 127:571-587. 10.1161/CIRCRESAHA.120.317447
- Zhou F, Yu T, Du R, et al.: Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020, 395:1054-1062. 10.1016/S0140-6736(20)30566-3
- Wenzhong L, Hualan L: COVID- 19: attacks the 1-beta chain of hemoglobin and captures the porphyrin to inhibit human heme metabolism [PREPRINT]. ChemRxiv. 2020, 10.26434/chemrxiv.11938173.v9
- Libby P, Lüscher T: COVID-19 is, in the end, an endothelial disease. Eur Heart J. 2020, 41:3038-3044. 10.1093/eurheartj/ehaa623
- Wiessman M, Shlomai A: Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med. 2018, 378:2539. 10.1056/NEJMc1805679
- Wang D, Hu B, Hu C, et al.: Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020, 323:1061-1069. 10.1001/jama.2020.1585
- Chen D, Li X, Song Q, et al.: Hypokalemia and clinical implications in patients with coronavirus disease 2019 (COVID-19) [PREPRINT]. MedRxiv. 2020, 10.1101/2020.02.27.20028530
- Siripanthong B, Nazarian S, Muser D, et al.: Recognizing COVID-19-related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management. Heart Rhythm. 2020, 17:1463-1471. 10.1016/j.hrthm.2020.05.001
- Tajbakhsh A, Gheibi Hayat SM, Taghizadeh H, et al.: COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up. Expert Rev Anti Infect Ther. 2021, 19:345-357. 10.1080/14787210.2020.1822737
- Esfandiarei M, McManus BM: Molecular biology and pathogenesis of viral myocarditis. Annu Rev Pathol. 2008, 3:127-155. 10.1146/annurev.pathmechdis.3.121806.151534
- Özer S, Bulut E, Özyıldız AG, Peker M, Turan OE: Myocardial injury in COVID-19 patients is associated with the thickness of epicardial adipose tissue. Kardiologiia. 2021, 61:48-53. 10.18087/cardio.2021.8.n1638
- Hurst RT, Prasad A, Askew JW 3rd, Sengupta PP, Tajik AJ: Takotsubo cardiomyopathy: a unique cardiomyopathy with variable ventricular morphology. JACC Cardiovasc Imaging. 2010, 3:641-649. 10.1016/j.jcmg.2010.01.009
- Medeiros K, O’Connor MJ, Baicu CF, et al.: Systolic and diastolic mechanics in stress cardiomyopathy. Circulation. 2014, 129:1659-1667. 10.1161/CIRCULATIONAHA.113.002781
- Tsuchihashi K, Ueshima K, Uchida T, et al.: Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction. J Am Coll Cardiol. 2001, 38:11-18. 10.1016/S0735-1097(01)01316-X
- Wittstein IS, Thiemann DR, Lima JA, et al.: Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005, 352:539-548. 10.1056/NEJMoa043046
- Jabri A, Kalra A, Kumar A, et al.: Incidence of stress cardiomyopathy during the coronavirus disease 2019 pandemic. JAMA Netw Open. 2020, 3:e2014780. 10.1001/jamanetworkopen.2020.14780
- Aranyó J, Bazan V, Lladós G, et al.: Inappropriate sinus tachycardia in post-COVID-19 syndrome. Sci Rep. 2022, 12:298. 10.1038/s41598-021-03831-6
- Heidari Gorji MA, Fatahian A, Farsavian A: The impact of perceived and objective social isolation on hospital readmission in patients with heart failure: a systematic review and meta-analysis of observational studies. Gen Hosp Psychiatry. 2019, 60:27-36. 10.1016/j.genhosppsych.2019.07.002
- Pantell M, Rehkopf D, Jutte D, Syme SL, Balmes J, Adler N: Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Am J Public Health. 2013, 103:2056-2062. 10.2105/AJPH.2013.301261
- Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A: The role of biomarkers in diagnosis of COVID-19 – A systematic review. Life Sci. 2020, 254:117788. 10.1016/j.lfs.2020.117788
- Dawson D, Dominic P, Sheth A, Modi M: Prognostic value of cardiac biomarkers in COVID-19 infection: a meta-analysis [PREPRINT]. Res Sq. 2020, 10.21203/rs.3.rs-34729/v1
- Zhu Z, Wang M, Lin W, et al.: Cardiac biomarkers, cardiac injury, and comorbidities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. Immun Inflamm Dis. 2021, 9:1071-1100. 10.1002/iid3.471
- Coomes EA, Haghbayan H: Interleukin-6 in COVID-19: a systematic review and meta-analysis. Rev Med Virol. 2020, 30:1-9. 10.1002/rmv.2141
- Long B, Brady WJ, Koyfman A, Gottlieb M: Cardiovascular complications in COVID-19. Am J Emerg Med. 2020, 38:1504-1507. 10.1016/j.ajem.2020.04.048
- Iorio A, Lombardi CM, Specchia C, et al.: Combined role of troponin and natriuretic peptides measurements in patients with COVID-19 (from the Cardio-COVID-Italy Multicenter Study). Am J Cardiol. 2022, 167:125-132. 10.1016/j.amjcard.2021.11.054
- Stavileci B, Özdemir E, Özdemir B, Ereren E, Cengiz M: De-novo development of fragmented QRS during a six-month follow-up period in patients with COVID-19 disease and its cardiac effects. J Electrocardiol. 2022, 72:44-48. 10.1016/j.jelectrocard.2022.02.012
- Kochi AN, Tagliari AP, Forleo GB, Fassini GM, Tondo C: Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol. 2020, 31:1003-1008. 10.1111/jce.14479
- Kociol RD, Cooper LT, Fang JC, et al.: Recognition and initial management of fulminant myocarditis: a scientific statement from the American Heart Association. Circulation. 2020, 141:69-92. 10.1161/CIR.0000000000000745
- Adeboye A, Alkhatib D, Butt A, Yedlapati N, Garg N: A review of the role of imaging modalities in the evaluation of viral myocarditis with a special focus on COVID-19-related myocarditis. Diagnostics (Basel). 2022, 12:549. 10.3390/diagnostics12020549
- Cau R, Bassareo P, Saba L: Cardiac involvement in COVID-19-assessment with echocardiography and cardiac magnetic resonance imaging. SN Compr Clin Med. 2020, 2:845-851. 10.1007/s42399-020-00344-7
- Weckbach LT, Curta A, Bieber S, et al.: Myocardial inflammation and dysfunction in COVID-19-associated myocardial injury. Circ Cardiovasc Imaging. 2021, 14:e012220. 10.1161/CIRCIMAGING.120.011713
- D'Andrea A, Cante L, Palermi S, et al.: COVID-19 myocarditis: prognostic role of bedside speckle-tracking echocardiography and association with total scar burden. Int J Environ Res Public Health. 2022, 19:5898. 10.3390/ijerph19105898
- Caforio AL, Pankuweit S, Arbustini E, et al.: Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013, 34:2636-2648. 10.1093/eurheartj/eht210
- Bihan H, Heidar R, Beloeuvre A, et al.: Epicardial adipose tissue and severe Coronavirus Disease 19. Cardiovasc Diabetol. 2021, 20:147. 10.1186/s12933-021-01329-z
Corresponding Author
Kashif Raza
Faculty, Department of Paramedical Sciences, Jamia Hamdard, New Delhi, India
DOI: https://dx.doi.org/10.18535/jmscr/v11i12.24
